Die Erscheinungsformen des Irreseins

Abstract

It has been repeatedly stated that research in clinical psychiatry has almost reached a dead end. It has been the practice for some time now to separate one disease from another with respect to causes, clinical findings, course, outcome and pathological findings.1 1 This practice has now outgrown its use. We must explore new avenues. We cannot, however, deny a certain justification for such practices. In the past, when tissue was first examined microscopically, new discoveries were made daily. Today we can only make significant progress by using very refined methods. In the case of some diseases many questions have already been answered. It is difficult to broaden our knowledge in such instances. The more we scratch below the surface, the more obvious the problems become and the more refined our tools need to be. In spite of all this our successes are becoming more modest. We shall have to resign ourselves to this state of affairs, which after all corresponds to that found in other branches of scientific enquiry.It is appropriate under these circumstances to ask whether new aims and methods will open up more promising vistas in the field of clinical research. We naturally will then turn our attention from merely classifying and categorizing diseases to a more exalted and satisfying exerciseunderstanding disease processes and how they inter-relate. We want to be able to bring order to the many confusing types of mental illness. We also aspire to an understanding of * All footnotes are by the translator.

Do schizoaffective disorders exist at all?

“…In this way, he created the so-called ÔKraepel-inian dichotomyÕ, which turned out to be clinically useful for subsequent decades. However, he himself got skeptical subsequently (2) if this simplistic solution really worked in practice as the number of Ôcases in-betweenÕ were too numerous.…”

Letter to the Editor: Co-morbidity and the concept of ‘emotional disorders’

“…It is regrettable that research into clinical psychopathology, the core of the discipline of psychiatry, has been back-staged by the ' atheoretical ' approach of current classifications. In the context of the ongoing debate about the future shapes of DSM and ICD, it may be of interest to revisit some halfforgotten earlier concepts, such as Kraepelin's idea of strata (' registers ') of psychopathology (Kraepelin, 1920), or the hierarchical ' classes of personal illness ' proposed by Foulds (1976). Without advocating their ' re-make ', we can perhaps extract from the perspective of such models biometrically testable propositions about the ways in which syndromes and symptoms segregate and recombine with each other to form patterns of personal illness, rather than an assemblage of unrelated ' disorders '.…”

Making Progress in Schizophrenia Research

“…Poor outcome was central to the original formulation of dementia praecox (hence the name). But Kraepelin questioned his original assertion that dementia praecox always leads to poor outcome 16 and suggested new diagnostic labels, including schizophrenia. 12 He acknowledged a lack of scientific data and radically changed his views on disease mechanisms and etiology.…”